Table Of ContentSimone Waldt
Klaus Woertler
fJThieme
'Thieme
Measurements and Classifications in
Musculoskeletal Radiology
Simone Waldt, MD Klaus Woertler, MD
Associate Professor Professor
Department of Radiology Deparnnent of Radiology
Klinikum rechts der Isar der Technischen Universitat Klinikum rechts der Isar der Technischen Universitat
Miinchen Miinchen
Munich, Germany Munich, Germany
With contributions by Matthias Eiber
423 illustrations
Thieme
Stuttgart · New York
Library of Congress Cataloging-in-Publication Data Important note: Medicine is an ever-changing science
Waldt, Simone, author. undergoing continual development. Research and clinical
[Messverfahren und Klassifikationen in der muskuloskel experience are continually expanding our knowledge, in
ettalen Radiologie. English] particular our knowledge of proper treatment and drug
Measurements and classifications in musculoskeletal therapy. Insofar as this book mentions any dosage or
radiology I Simone Waldt, Klaus Woertler ; translator, application, readers may rest assured that the authors,
Terry C. Telger ; illustrators, Christiane and Dr. Michael editors, and publishers have made every effort to ensure
Solodkoff. that such references are in accordance with the state of
p.;cm. knowledge at the time ofp roduction of the book.
"This book is an authorized translation of the 1st German Nevertheless, this does not involve, imply, or express any
edition, Messverfahren und Klassifikationen in der guarantee or responsibility on the part of the publishers
muskuloskelettalen Radiologie." in respect to any dosage instructions and forms of ap
Includes index. plications stated in the book. Every user is requested to
ISBN 978-3-13-169271-9 (alk. paper)-ISBN 978-3-13- examine carefully the manufacturers' leaflets accompa
169281-8 (e-book) nying each drug and to check, if necessary in consultation
I. Woertler, Klaus, author. II. Telger, Terry C., translator. with a physician or specialist, whether the dosage sched
Ill. Title. ules mentioned therein or the contraindications stated by
(DNI.M: 1. Musculoskeletal Diseases-classification. 2. the manufacturers differ from the statements made in the
Diagnostic Imaging -classification. WE 15] present book. Such examination is particularly important
RC925.7 with drugs that are either rarely used or have been newly
616.7'075-dc23 released on the market. Every dosage schedule or every
2013039501 form of application used is entirely at the user's own risk
and responsibility. The authors and publishers request
This book is an authorized translation of the 1st German every user to report to the publishers any discrepancies or
edition, published 2011 by Georg Thieme Verlag KG, inaccuracies noticed. If errors in this work are found after
Stuttgart, Germany. Title of the German edition: publication, errata will be posted at www.thieme.com on
Messverfahren und Klassijikationen in der muskuloskelet the product description page.
talen Radiologie.
Translator: Terry C. Telger, Fort Worth, Texas, USA
Illustrators: Christiane and Dr. Michael Solodkoff,
Neckargemiind, Germany
Contributor: Matthias Eiber, MD, Department of
Radiology, Klinikum rechts der Isar der Technischen
Universitat Miinchen, Munich, Germany
() 2014 Georg Thieme Verlag KG,
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Preface
"The best books are those whose readers believe they it matched the charm of the old binder, the digital col
themselves could have written." lection was surely more modern, better organized, more
Blaise Pasca~ French mathematician, accessible, and definitely more sanitary than the original.
physicist and philosopher (1623-1662) Moreover, it was the direct precursor of this book.
While not exhaustive, this book presents a great va
There is scarcely any subspecialty of clinical medicine riety of measuring techniques and classification systems
in which we find such a bewildering array of measuring drawn from all areas of musculoskeletal radiology (except
techniques and classification systems as in orthopedics. for fractures, which would fill another book). The authors
They are so numerous that every radiologist, orthopedist, have tried to refer back to original publications when
or trauma surgeon cannot possibly keep all the methods ever possible in order to eliminate any inaccuracies that
and reference values "in their head." This problem, like may have been introduced over time. Besides explaining
the concept for this book, is not new. measurement techniques and classification criteria, we
When I began studying orthopedic radiology during have tried to note the actual, practical value of specific
my training at the University of Munster, an important methods. Outmoded practices and systems were either
tool in our reading room was a ring binder stuffed with excluded from this collection or were included with ap
separate pages that had been copied from various text propriate comments.
books and journals. The pages, assembled in random This book cannot replace a textbook. It is intended
order by my predecessors, covered important measure as a handy reference for everyday use that will provide
ments and classifications that, while used with some students and instructors with an "external memory" for
frequency, were apparently difficult for the users to things that are difficult to remember and, in many cases,
retain in their long-term memory. The ring binder and need not be committed to memory. Of course, it is not
its contents, which had become tattered and unsightly enough simply to measure angles and juggle classifica
over the years, was referred to by my colleagues and me tions. We suggest that you take the time saved by using
simply as the "binder." We considered it an indispensible this book, and spend it gaining a sound basic knowledge
aid, guarded it jealously, and were constantly adding new of orthopedic diagnosis or expanding the knowledge that
pages and notes of our own. you already have. There are many ways of doing this.
Later, residents in orthopedic radiology training at the I hope that this book will serve its readers as effec
Technische Universitat Munchen compiled a very similar tively as the "binder" served me in its time. I plan to use
collection, though in digital form. While I never felt that it, anyway.
Klaus Woertler
Munich, Germany
v
Abbreviations
AASA Anterior acetabular sector angle IKDC International Knee Documentation
AHD Acromiohumeral distance Committee
AHL Anterior humeral line in Inch(es)
A]CC American ]oint Committee on Cancer IS, ISP Infraspinatus
aLDFA Anatomic lateral distal femoral angle ]C ]oint cartilage
aMPFA Anatomic medial proximal femoral LBC Labral-bicipital complex
angle LDTA Lateral distal tibial angle
ALPSA Anterior labral periosteal sleeve u Lumbar index
avulsion LLC Labral-Iigamentous complex
AP Anteroposterior LPFA Lateral proximal femoral angle
ARCO Association Research Circulation LUCL Lateral ulnar collateral ligament
Osseous MCS Medial clear space
ASNR American Society of Neuroradiology MCP Metacarpophalangeal
ASSR American Society of Spine Radiology MHZ Megahertz
ASRS American Scoliosis Research Society mLDFA Mechanical lateral distal femoral angle
AT angle Angle of femoral anteversion mLPFA Mechanical lateral proximal femoral
BHAGL Bony humeral avulsion of glenohu- angle
meralligaments MPFA Medial proximal femoral angle
CCDangle Projected femoral neck-shaft angle MPNST Malignant peripheral nerve sheath
(NSA) tumor
CEangle Center-edge angle (of Wiberg) MPTA Medial proximal tibial angle
CIC Carpal instability complex MRI Magnetic resonance imaging
CID Concealed interstitial delamination; MT Main thoracic
carpal instability dissociative MTP Metatarsophalangeal
CUP Capitolunate instability pattern MUCL Medial ulnar collateral ligament
CIND Carpal instability, nondissociative NASS North American Spine Society
CSV Central sacral vertical line NOS Not otherwise specified
CT Computed tomography OARS Osteoarthritis Research Society
DDH Developmental dysplasia of the hip OCD Osteochondritis dissecans
DIS I Dorsiflexed intercalated segment OMERACT Outcome Measures in Rheumatoid
instability Arthritis Clinical Trials
DM Double major PA Posteroanterior
DMAA Distal metatarsal articular angle PAINT Partial articular-sided with intratendi-
DT Double thoracic nous extension
DXA Dual X-ray absorptiometry PASA Posterior acetabular sector angle
ED angle Epiphyseal-diaphyseal angle PASTA Partial articular-sided supraspinatus
ET angle Epiphyseal torsion angle tendon avulsion
FAI Femoroacetabular impingement PIP Proximal interphalangeal joint
FDP Flexor digitorum profundus PISI Palmar-flexed intercalated segment
FDS Flexor digitorum superficialis instability
GCTTS Giant cell tumor of tendon sheaths PNET Primitive neuroectodermal tumor
GLAD Glenolabral articular disruption PPL Parallel pitch lines
HAGL Humeral avulsion of glenohumeral PTS Posterior tibial slope
ligaments PVNS Pigmented villonodular synovitis
HASA Horizontal acetabular sector angle QCT Quantitative computed tomography
HTEangle Horizontal toit externe (acetabular ROI Region of interest
index of the weight-bearing zone) RUS Radius, ulna, and short bones
HU Hounsfield unit SCFE Slipped capital femoral epiphysis
ICRS International cartilage Repair Society SCOI Southern California Orthopedic
IGHL Inferior glenohumeral ligament Institute
VI
Abbreviations
SD Standard deviation TFO Tibiofibular overlap
SGHL Superior glenohumeral ligament TM Teres minor, triple major
SLAC Scapholunate advanced collapse TMT Tarsometatarsal
SLAP lesion Superior labral anterior to posterior TT angle Tibial torsion angle
lesion TTTG Tibial tuberosity trochlear groove
SMS Skeletal maturity score UICC Union lnternationale Contre le Cancer
sse
Subscapularis UTL Ulnar translation
v
SS, SSP Supraspinatus Volt(s)
STAS Supraspinatus tendon articular-sided WHO World Health Organization
partial tear. not at the footprint WOMAC score Western Ontario and McMaster osteo-
TCS Total dear space arthritis score
TFCC Triangular fibrocartilage complex
VII
